Janae Stevenson was on the hunt for her first “big girl job” when her symptoms hit in 2021. Months after graduating from Arizona State University, she began suffering bouts of severe stomach pain, diarrhea and vomiting.
Doctors said she needed her gallbladder removed, a surgery that cost thousands of dollars. Her family’s insurance only covered around 20% of the procedure and without Arizona’s Medicaid program, Stevenson said she and her parents, who work in education and social work, would have struggled to afford the emergency expense.
The program, she said, helped her heal enough to find her first job and get her own private health insurance.
But as questions swirl over whether Congress’ recent budget proposal will put Medicaid on the chopping block, and by how much, Stevenson said she fears for the millions of people around the country who depend on the program.
More:Medicaid insures 1 in 5 Americans. This is how the GOP budget could impact coverage.
“Cuts to Medicaid won’t just harm my family and won’t just harm our communities in the present,” said Stevenson, who now works in advocacy at the National Domestic Workers Alliance. “These make it so that people like me wouldn’t be able to receive a surgery that they might need.”
If agreed upon by the Senate, the budget resolution passed this week by the Republican-led House would extend the 2017 tax cuts that mostly benefited wealthier Americans, and require the federal government to slash $2 trillion in spending.
Budget experts warn the plan could require dramatic changes and cuts to Medicaid, the federal health insurance program that covers more than 70 million Americans, or roughly one in five people across the country.
It still remains unclear if, and how, Congress could curtail Medicaid spending. But any cuts could impact large swaths of the American public.
About 60% of American adults have either used Medicaid for health care coverage or know a family member or close friend who has used the program, according to a recent survey conducted by The Kaiser Family Foundation.
“The majority of people in the United States have been personally touched by Medicaid. And the reality is that even if they haven’t yet, they may be in the future,” said Joan Alker, executive director of Georgetown University’s Center for Children and Families.
Nearly half of U.S. children on Medicaid
Medicaid covered roughly four in 10 births in the U.S. in 2021, and nearly half of America’s children receive medical coverage through the program.
Many children are on Medicaid partially because they are less likely than their parents to have access to employer-sponsored insurance, Alker told USA TODAY. Private insurance plans offered by employers often don’t include affordable options for dependent coverage, she said.
In 2022, family premiums for employer-sponsored health insurance averaged more than $22,000 a year, according to a study published by The Kaiser Family Foundation.
More:Maternal deaths are dropping, but these moms still face high risk.
For some children, including those with chronic illness and special needs, Medicaid may also act as supplemental insurance providing benefits that would otherwise go uncovered.
Medicaid covers nearly half of children with special needs. A recent report published by Georgetown’s Center for Children and Families also found that one in 10 children of active-duty service members have Medicaid coverage in addition to their military-sponsored health care.
Military families are more likely than those in the civilian sector to have children with special health or mental health needs, the report said.
Rural Americans disproportionately rely on Medicaid
Americans living in rural areas are more likely than their peers in cities to need Medicaid coverage.
Roughly a quarter of rural residents under age 65 rely on Medicaid, according to a 2021 study published by The Medicaid and CHIP Payment and Access Commission, a government agency that makes recommendations to the Department of Health and Human Services.
The reasons are varied. People in small towns and rural areas are more likely to work in jobs, such as agriculture and seasonal work, that don’t offer comprehensive health care coverage, Alker said.
They’re also more likely to have lower incomes than people living in other areas, are often older and have higher rates of disability, according toa 2017 study published by The Kaiser Family Foundation.
Older adults needing long term care and their families
Medicaid is the largest insurance provider of long-term care services and supports, such as nursing home and home health care needs, that help aging adults and people with disabilities with daily life activities. The Kaiser Family Foundation estimates that around 6 million people use Medicaid for long term care solutions.
The high cost of long term care leads many older Americans, even those in the upper and middle class, to exhaust their savings. In 2023, the median annual cost of a home health aid was more than $75,000, according to the long term care site Care Scout. A semi-private room in a nursing home cost $104,025 on average.
Stevenson, who is now 24, said that when her grandfather began exhibiting signs of dementia, his veteran’s healthcare wouldn’t cover the care. Her family again turned to Medicaid for help with the expenses. Without the care, Stevenson said she or her mother would have needed to quit their jobs to give him around-the-clock assistance.
Many Americans will face the burden of needing to care for an older parent.
A 2020 reported published by the National Alliance for Caregiving and AARP found that about one in five of the estimated 53 million caregivers in this country care for an adult. Many remain in the workforce while caring for their loved one. But the study found that those who temporarily exit the workforce in their 40s and 50s to face long term financial losses.
Typically, women are also more likely to quit work to care for needy family members than men.
More:If you think you’ll never need long-term care in retirement, you’re probably wrong
Long term care coverage is among the most at risk Medicaid services if the program receives federal cuts, said Katherine Hempstead, a senior policy adviser at the Robert Wood Johnson Foundation, because they are among the optional services states can provide, rather than the measures they are federally mandated to cover.
If her grandfather’s Medicaid coverage changed, Stevenson said it would be “devastating.”